Healthcare Provider Details

I. General information

NPI: 1386445864
Provider Name (Legal Business Name): ADAGIO COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6104 E 76TH PL
TULSA OK
74136-8548
US

IV. Provider business mailing address

6104 E 76TH PL
TULSA OK
74136-8548
US

V. Phone/Fax

Practice location:
  • Phone: 918-999-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JAMES BURNHAM
Title or Position: MANAGING DIRECTOR
Credential: EDD, LPC
Phone: 918-999-1200